Fax Order Form:
Please send me
Title ___________________________________________ Quantity
_______________
Title ___________________________________________ Quantity
_______________
Title ___________________________________________ Quantity
_______________
Title ___________________________________________ Quantity
_______________
Title ___________________________________________ Quantity
_______________
Total _______________
Plus, until May 31, 2009 get
one
free 3-tier display with your mix-n-match order of
250 brochures and two
displays with orders of 500 or more brochures.
(Actual shipping expense add'l) Shipping (please circle): UPS
Overnight 2-Day
Name
_____________________________________________________________________________
Organization
________________________________________________________________________
Address
___________________________________________________________________________
City _____________________________________________State
_________ Zip_________________
Phone __________________________________ Fax:
______________________________________
email
_____________________________________________________________________________
My signature confirms my agreement to the payment terms
__________________________________________________________________________________
[ ] Send an invoice (Members only. I agree to pay w/in
30 days of receipt)
[ ] Charge my credit card (charged when shipped) [
] VISA [ ] MasterCard [ ] AMEX
Card Number
_______________________________________________________________________
Exp. Date: ________ Name on Credit Card (print)
__________________________________________
Return form to
Jacques Jenkins.
Fax:
301-585-4219.
Mail:
NRMCA, 900 Spring St., Silver Spring, MD 20910.
Email:
jjenkins@nrmca.org
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Plus,
until May 31 get a FREE 3-tier display with
your mix-n-match order
Click 
Click 
Click 
Click 
